The Patients Equal Access Coalition Applauds a New Bill to Improve Access to Oral Cancer Drugs

The federal Cancer Drug Coverage Parity Act will dramatically improve the lives of cancer patients. Patients who previously could not afford these treatments will be able to access their life‐saving effects. It will also make cancer treatments more practical for patients living in rural and underserved areas by reducing the need to drive long distances for a nurse or doctor to administer treatment.

The Patients Equal Access Coalition Applauds a New Bill to Improve Access to Oral Cancer Drugs

Washington, DC, May 2, 2013--The Patients Equal Access Coalition (PEAC) commends Congressman Brian Higgins (NY-26th District) on the introduction of the Cancer Drug Coverage Parity Act, H.R. 1801 on April 26. This bill is a critical step toward improving access to anticancer treatments by requiring insurance companies to cover patient-administered and physician-administered anticancer drugs at the same cost to patients.

As the science surrounding cancer treatment continues to improve, the number of chemotherapy drugs that can be self-administered by patients continues to grow. In some cases, they may be the only drug proven to treat a specific type of cancer.

To date, insurance coverage policies for these drugs have not kept up with scientific advancement. Patients who rely on self-injectables or chemotherapy pills find themselves spending as much as $50,000 a year out of pocket because they receive the drugs from a pharmacy rather than in a doctor’s office.

“For patients living with cancer across the country, this bill will mean one less thing to worry about. They will no longer have to decide between the best treatment and financial stability, and can focus on what really matters: beating their cancer,” said Meghan Buzby, Director of U.S. Advocacy for the International Myeloma Foundation (IMF). The IMF leads the coalition of organizations representing patients, health care professionals, care centers, and industry.

The legislation will benefit thousands of cancer patients across the country, including Patrick Dee of Knoxville, Tenn., a patient and advocate with the National Brain Tumor Society, who said, "Oral chemotherapy patients like me need this legislation. I don't have a choice. I must have access to oral chemotherapy in order to battle a brain tumor. Being able to take oral chemotherapy right at home also helps me take fewer sick days from work.”

“As providers, we are often forced to choose between the best treatment for patients, and what they can afford. This bill would eliminate the cost difference between self-administered and physician- or clinic-administered cancer drugs, and allow physicians to prescribe the most appropriate chemotherapy for the patient,” said Niesha Griffith, a hematology/oncology pharmacist and president of the Hematology/Oncology Pharmacy Association.

The heavy financial burden often also forces patients to skip doses to save money, which impacts the drugs’ effectiveness and puts the patients’ lives at greater risk. “Part of our job is to make sure that patients are taking their medications as prescribed. However, due to the costs of some oral and self injectable chemotherapy, our patients cannot always comply. This bill would make these medications more accessible and improve the efficacy of the treatment,” Griffith said.

The Cancer Drug Coverage Parity Act will dramatically improve the lives of cancer patients. Patients who previously could not afford these treatments will be able to access their life-saving effects. It will also make cancer treatments more practical for patients living in rural and underserved areas by reducing the need to drive long distances for a nurse or doctor to administer treatment.

“Restricting access to medication that is the best and, often, only viable treatment option for cancer patients is a practice that makes sense neither medically nor financially,” said Dr. Donald Trump, president and CEO of Roswell Park Cancer Institute. "Many of the emerging and most effective cancer therapies are available only in an oral form; our payment systems need to keep pace with innovation.”

To date, 23 states have passed similar laws to increase access to these life-saving drugs. To expand this to all cancer patients in the country, we need a federal law that sets a standard across all states so that all cancer patients can access both physician and patient administered chemotherapy.

The Patients Equal Access Coalition (PEAC) is a patient-focused coalition of 26 organizations representing patients, health care professionals, care centers, and industry, which have joined together to ensure that cancer patients have equality of access (and equality of insurance coverage) to all approved anticancer regimens including, but not limited to oral and intravenous drugs, injection, surgery, radiation, and transplantation. PEAC believes that every cancer patient should have access to the anticancer regimens recommended by their physicians and should not suffer from cost discrimination based on the type of therapy provided or the mechanism of delivery. For more information and a list of members, please visit our webpage:http://peac.myeloma.org

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IMF advocate Tom Chellius and National State Affairs Consultant Zina Cary testified this week at a hearing held by the Wisconsin State Senate Insurance & Housing Committee in support of Senate Bill 300 (Cancer Treatment Fairness Act). The bill would require insurers in Wisconsin to cover oral anticancer therapies at rate equal to intravenous, or IV, treatments. Joining the IMF in the packed hearing room were members of the Wisconsin Coalition for Cancer Treatment Access (WCCTA) and the bill's legislative champions, State Senator Alberta Darling and State Representative Pat Strachota.

The IMF participated in a congressional briefing, “Multiple Myeloma & Rare Blood Cancers: Living With Multiple Myeloma, Innovations in Treatment and Patient Access to Care,” organized by the California Healthcare Institute and Onyx Pharmaceuticals.

IMF's Advocacy team this week registered its disappointment with amendments recently added to the original bill (AB 219) to increase the cap for out-of-pocket expensesâ€”from $100 to $200â€”for patients taking oral anticancer treatments. The original intent of this bill was to eliminate the cost disparity between oral and intravenous anticancer medications, ensuring access to all anticancer medications for cancer patients. Additional proposed changes allow insurers to increase the cap over time, delay the implementation date until 2015, and sets the law to expire in 2019. California voters can contact their state senators to oppose the amendments.

Next up in our Patient Education Series on the Affordable Care Act: Learn the alphabet soup of private health insurance changes coming in 2014 – QHPs, EHBs, OOPs, marketplaces and more! Join us to hear from a panel of experts from think tanks and policy groups who will discuss what cancer patients and their families need to know nowabout the health insurance world in 2014.

The federal Cancer Drug Coverage Parity Act will dramatically improve the lives of cancer patients. Patients who
previously could not afford these treatments will be able to access their life‐saving effects. It will also make cancer treatments more practical for patients living in rural and underserved areas by reducing the need to drive long distances for a nurse or doctor to administer treatment.

This summer the IMF formed the State Patients Equal Access Coalition (SPEAC), which is a patient-focused coalition working collaboratively to ensure that cancer patients have appropriate access to a broad range of approved and medically-accepted anticancer regimens.

The IMF Advocacy Team has seen major growth this year with two new additions. We are proud to announce that because of our team growth we have been able to expand our reach to help myeloma patients around the world get access to the treatments they need.

"My role as a myeloma specialist is to treat patients with the newest, most-effective treatments," said Dr Arthur Molina, Ochsner’s Director of Bone Marrow Transplantation and Hematological
Malignancies. "I am concerned when patients tell me they would rather have an older, less tolerable drug because
their insurance plan will reimburse them at a higher rate."